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Eagle Academy II Scholar Blue Card 2023-24
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Email
*
Your email
Scholar LAST Name
*
Your answer
Scholar FIRST Name
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Your answer
Scholar Middle Name
Your answer
Scholar OSIS / Student ID Number (if you know it)
Your answer
Scholar is entering grade...
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6
7
8
9
10
11
12
Date of Birth
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MM
/
DD
/
YYYY
Parent/Guardian Scholar resides with:
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Your answer
Relationship
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Your answer
Parent/Guardian's Preferred Language of Communication
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English
Spanish
Other:
Cell Phone # of Primary Parent/ Guardian
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Your answer
Are you able to receive text messages at this phone #?
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Yes
No
Email of Primary Parent/ Guardian (Please type carefully)
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Your answer
Address
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Your answer
Apt#
Your answer
Borough
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Brooklyn
Queens
Bronx
Staten Island
Manhattan
Zip Code
*
Your answer
Other Parent/ Guardian (if applicable)
Your answer
Other Parent/ Guardian Relationship (if applicable)
Your answer
Cell Phone # of other parent/guardian (if applicable)
Your answer
Is this number able to receive text messages?
Yes
No
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Email Address of other parent/ guardian (Please type carefully)
Your answer
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